Family Dynamics of Caregiving

By Pamela D. Wilson, MS, BS/BA, NCG, CSA

Navigating the family dynamics of caregiving can be challenging. Many family members, including aging parents disagree on how or where care should be provided. When these concerns were not previously discussed and a crises occurs, family disagreements are common due to the pressure of having to make a decision. Decisions made in crises may not always be the best due to having limited information. Consulting a caregiving expert is a prudent course of action.

In our busy world, caregiving can become a complicated task especially when multiple family members are involved.  Who will take responsibility for what tasks? Often the majority of the work is delegated to the family member who has the most available time.  Caregivers placed in this position feel that this is not always fair and that their brothers, sisters, or other family members take advantage of their availability and generosity.  This resentment creeps into family relationships and sometimes results in the need for legal intervention.

The individual with the majority of the caregiving burden physically and emotionally burn out. Their physical and emotional health may fail. Statistics report that caregiver stress is at an all time high resulting in physical and emotional health declines.  Exhausted caregivers are taken to task by family members for not doing more.  Or the caregivers themselves feel guilty that they are not doing enough to care for the family member.

Many times debating who and how much care should be provided is a no win situation unless other family members will commit to providing support through time or money.  Sometimes abuse occurs within the family and one individual takes liberties with mom or dad’s bank account. Other times physical or emotional abuse occurs. The abuse, usually unintentional, results in a situation that escalates.

Signs of caregiver exhaustion can be seen in the older adult through poor general appearance or hygiene, poor nutrition, dehydration, lack of socialization or missed medical appointments.  At times the primary caregiver is so exhausted that they do not notice weight loss or other changes in the older adult that may be seen by other visiting family members who express concern. Because of stress and lack of attention to details, important changes that necessitate medical care may be missed.

While family members may want to rely on a single family member, this is not in the best interest of the aging person or the individual who needs care. When unintentional neglect and harm occurs, who then should be to blame? The exhausted caregiver or the family members who failed to acknowledge the seriousness of the situation. No one is free from blame or responsibility.

It is at this point that family disagreements occur about the best care for the older adult.  Some family members may recommend community placement or in home care because they feel the primary caregiver is unable to provide the best care. One child may feel that another just wants to put mom or dad “away”.  Another child may feel that not enough is being done and that other family members are being negligent

How do family caregivers determine what is in mom or dad’s best interests and which family members will act responsibly and ethically?  This isn’t always easy to determine.  In addition to daily care needs there is also a maze of related and corresponding issues.

Frequently even when elder law, probate, or estate planning attorneys, financial or wealth planners are involved, a caregiving expert should be consulted. The caregiving expert is able to provide background information on short and long term needs, care costs, and care alternatives. The provision of costs is important so that financial and wealth planners may take this into consideration for future needs. Being realistic about care wishes and costs is important. Medicaid may be part of the future plan if resources are not sufficient to last the projected lifetime of the client.

Many times a compromise is the best course of action for the older adult and the entire family.  The primary caregiver may feel unappreciated or victimized because other family members feel he or she is not providing the best care.  While neither side may want to be seen as “giving in” it may be in the best interests of the entire family to compromise and collaborate for the best solution. This may mean that not everyone has their desires granted.

Many older adults would prefer to remain at home if the cost of care is not prohibitive or if the care necessary does not exceed what can be provided. Families should know that there are many options available for assistance so that any one family member need not be overwhelmed and the best interest of the person needing care is the priority.  In situations where there are differing opinions, attorneys and financial planners will consult a caregiving expert who is able to add to the life plan of the client. This consultation is time and money well spent.

© 2012, 2013, 2018 Pamela D. Wilson All rights reserved.

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